After a promising return from the injured list, Chicago Cubs lefty Jose Quintana is back on it with left lat inflammation, the team announced on Wednesday afternoon.

Quintana, 31, has missed most of this season after cutting his pitching hand while washing dishes during baseball's shutdown. He returned last week, appearing in two games in relief, and was heading toward a starting spot in the rotation before the latest injury sidelined him.

On Tuesday, the Cubs placed righty Tyler Chatwood on the 10-day injured list with an elbow strain so the team has lost two starters in two days.

In six innings Quintana had a 6.00 ERA with nine strikeouts and two walks, but his ERA was inflated by a rough ending to his first outing.

Righty reliever Jason Adam was called up from the alternate site to take Quintana's place in the rotation but another righty, Adbert Alzolay, is likely to get a start soon. He threw five innings against the Cardinals without giving up an earned run in his lone start of the season. Alzolay has spent most of his time at the Cubs alternate site this year.

The Cubs have 14 games in 13 days before their next off day including a doubleheader against the Cardinals this Saturday. They lead St. Louis by three games in the NL Central entering play on Wednesday.

With Chatwood healthy, Quintana had started in the bullpen. The Cubs are less desperate for left-handers there now after acquiring Josh Osich and Andrew Chafin at the trade deadline. Osich is in on the active roster, while Chafin is recovering from a sprained finger and is a few weeks away from returning.